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GENERAL OTOLARYNGOLOGY > CHAPTER 4: History, Physical Examination and the Preoperative Evaluation > Flashcards

CHAPTER 4: History, Physical Examination and the Preoperative Evaluation Flashcards

1
Q

Indicative of temporal bone fracture

A

Battle sign (ecchymosis overlying the mastoid)

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2
Q

To straighten the canal and allow atraumatic insertion of the otoscopic speculum

A

Gently grasp the pinna and elevate it superiorly and posteriorly

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3
Q

TRUE or FALSE

The lateral process of the malleus is readily seen in the superior TM and will be quite prominent in retracted membrane

A

TRUE

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4
Q

TM lacks the radial and circular fibers

A

Pars flaccida

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5
Q

Most common location for retraction pockets, debris, and cholesteatoma

A

Pars flaccida

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6
Q

TRUE or FALSE

The normal TM should be pearly gray and translucent

A

TRUE

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7
Q

A thickened, erythematous membrane, occasionally with bullae

A

Myringitis

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8
Q

A thin atelectatic membrane draped closely over the underlying middle ear structure

A

Adhesive otitis media

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9
Q

Prominent radial blood vessels

A

Chronic middle ear effusion

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10
Q

Often appear as amber fluid, sometimes with air-fluid levels or air bubbles

A

Serous effusions

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11
Q

Appear dull gray to white in color, with loss of the typically visualized middle ear landmarks, and the TM will often be retracted

A

Mucoid effusions

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12
Q

Mass blanches with pneumatic otoscopy

A

Brown sign

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13
Q

Tuning fork tests is done to distinguish between a sensorineural and conductive hearing loss with a

A

512-Hz fork

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14
Q

Performed by placing the vibrating 512-Hz tuning fork in the center of the patient’s forehead, at the bridge of the nose, or on the central incisors with the patient’s teeth tightly clenched

A

Weber test

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15
Q

The 512-Hz tuning fork is placed firmly on the mastoid process, and the patients are instructed to tell the examiner when they are no longer able to hear the sound. The fork is then quickly transferred in front of the ear canal, and patients are asked if they can hear the sound

A

Rinne test

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16
Q

NPCA most commonly presents in the

A

Fossa of Rosenmuller

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17
Q

Boundaries of the oral cavity

A
  1. Skin-vermillion junction of the lips
  2. Hard palate
  3. Anterior 2/3 of the tongue
  4. Buccal membranes
  5. Upper and lower alveolar ridge
  6. Retromolar trigone
  7. Floor of the mouth
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18
Q

Parotid duct or Stenson duct opens near the

A

2nd upper molar

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19
Q

Small yellow spots in the buccal mucosa are sebaceous glands

A

Fordyce spots

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20
Q

Oropharynx area

A
  1. Posterior 3rd of the tongue
  2. Anterior and posterior tonsillar pillars
  3. Soft palate
  4. Lateral and posterior pharyngeal wall
  5. Vallecula
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21
Q

Tonsil size/scale

A

Brodsky scale

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22
Q

Indicates the tonsils are entirely within the tonsillar fossa

A

0

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23
Q

Indicates the tonsils are located just outside the fossa and occupy <25% of the total width of the oropharynx

A

1+

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24
Q

Tonsils occupy 26%-50%

A

2+

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25
Q

Tonsils are 51%-75% of the oropharyngeal width

A

3+

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26
Q

Tonsils occupy >75% of the oropharyngeal width

A

4+

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27
Q

Larynx is subdivide into

A
  1. Supraglottis
  2. Glottis
  3. Subglottis
28
Q

Area of supraglottis

A
  1. Epiglottis
  2. Aryepiglottic folds
  3. False vocal cords
  4. Ventricles
29
Q

Area of glottis

A
  1. Inferior floor of the ventricle
  2. True vocal folds
  3. Arytenoids
30
Q

Area of subglottis

A

Begin 5-10mm below the free edge of the true vocal fold And to extend to the inferior margin of the cricoid cartilage

31
Q

Extends from the superior edge of the hyoid bone to the inferior aspect of the cricoid cartilage

A

Hypopharynx

32
Q

Subsites of hypopharynx

A
  1. Piriform sinuses
  2. Posterior hypopharyngeal wall
  3. Postcricoid area
33
Q

Correct positioning in indirect laryngoscopy

A
  1. Patient’s legs should be uncrossed and placed firmly on the footrest
  2. The back should be straight with the hips planted firmly against the chair
  3. While leaning slightly forward from the waist, the patient should place the chin slightly upward in a sniffing position
  4. The patient’s tongue is pulled forward by the examiner
  5. The examiner’s middle finger is extended to retract the patient’s upper lip superiorly, and a dental mirror is warmed to prevent fogging and is placed in the oropharynx to elevate the uvula and soft palate to view the larynx
34
Q

Divides the neck into a posterior triangle and anterior triangle

A

SCM

35
Q

Posterior triangle comprises of

A

Supraclavicular and occipital triangles

36
Q

Anterior triangle comprises of

A
  1. Submandibular
  2. Carotid
  3. Muscular
37
Q

Defined by the body of the mandible, the anterior belly of the contralateral digastric muscle, and the stylohyoid muscle

A

Level I

38
Q

Contains submental nodes

A

Level IA

39
Q

Consists of the submandibular nodes

A

Level IB

40
Q

Levels IA and IB are separated by the

A

Ipisilateral anterior belly of the digastric muscle

41
Q

Upper third of the jugulodigastric chain is known as

A

Level II

42
Q

Middle jugulodigastric chain

A

Level III

43
Q

Lower jugulodigastric chain

A

Level IV

44
Q

Located medial to the plane defined by the spinal accessory nerve

A

Sublevel IIA

45
Q

Lateral to the spinal accessory nerve

A

Sublevel IIB

46
Q

Extends from the inferior border of the hyoid bone to the inferior border of the cricoid catilage

A

Level III

47
Q

Located from the inferior border of the cricoid to the superior border of the clavicle

A

Level IV

48
Q

Anterior and posterior boundary of levels II and IV

A

Anterior: lateral border of the sternohyoid muscles
Posterior: lateral border of the SCM

49
Q

Encompasses the posterior triangle (spinal accessory and supraclavicular nodes)

A

Level V

50
Q

Encompasses the nodes from the lateral border of the SCM to the anterior border of the trapezius muscle

A

Level V

51
Q

TRUE or FALSE

Virchow node is not in the VB region but is located in level IV

A

TRUE

52
Q

Pretracheal, paratracheal, precricoid (delphian), and perithyroid nodes

A

Level VI

53
Q

Most common cause of perioperative mortality

A

Cardiovascular complications

54
Q

Second most common cause of perioperative mortality

A

Pulmonary complications

55
Q

Inhibits both thyroid hormone synthesis and the peripheral conversion of T4 to T3

A

Propylthiouracil

56
Q

Inhibits iodide organification

A

Potassium iodide (Lugol solution)

57
Q

Inhibits abnormal bone resorption

A

Etidronate

58
Q

Inhibits parathyroid hormone induced osteoclastic activity

A

Mithramycin

59
Q

Direct inhibition of osteoclast activity

A

Calcitonin

60
Q

Most common cause of hypoparathyroidism

A

Iatrogenic

61
Q

Facial nerve hyperactivity elicited by tapping over the common trunk of the nerve as it passes through the parotid gland)

A

Chvostek sign

62
Q

Finger and wrist spasm after inflation of a blood pressure cuff for several minutes

A

Trousseau sign

63
Q

Primary aldosteronism

A

Conn syndrome

64
Q

Aldosterone antagonist

A

Spironolactone

65
Q

Idiopathic primary adrenal insufficiency

A

Addison disease

66
Q

,substitution of valine for glutamic acid in the 6th position of the beta-chain of the hemoglobin molecule

A

Sickle cell disease

GENERAL OTOLARYNGOLOGY (12 decks)

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